Infections of the genitourinary tract caused by sensitive Gram-positive and Gram-negative microorganisms

Dossage

Adults: the recommended dose is one capsule twice
daily at 12 hours intervals, preferably after meals.
As with other urinary-tract infections it is advisable to
prolong treatment for at least 10 days to prevent the
possibility of recurrence.
In cases of chronic and recurrent infections,
UROTRACTIN can be administered for a prolonged
period and is well tolerated due to its low toxicity.
Children of over 14 years of age can follow the adult
dose. While taking UROTRACTIN , it is advisable not
to expose oneself for longer periods to the sun as there
is a risk of photosensitivity reaction with a possible consequence
of bullous dermatitis

ATTENTION
1. When hypersensitive reactions occur and symptoms resemble
Shock, treatment stopped.
2. Given with caution in sufferers with
Decreased kidney function, and adjust dose to
Severe renal dysfunction. Elderly sufferers may
Require dose reduction, as it usually is
Creatinine clearance has decreased.
3. Be careful when given during childbearing.
4. Absorption in the intestine will decrease when given
Together with antacids containing
Aluminum or magnesium hydroxide. Because it is given
1 - 2 hours before or after Ofloxacin.

Amoxicillin is susceptible to degradation by betalactamase and therefore the spectrum of activity of AMOXSAN ® does not include organisms which produce these enzymes, including resistant staphylococci and all strains of Pseudomonas, Klebsiella and Enterobacter.

Dossage

Posology and method of administration AMOXSAN® Dispersible Tablet may be given without regard to meals.
Dissolve one dispersible tablet in approximately one spoonful of drinking water, wait for about 50 seconds until the tablet is completely dispersed into small granules. The suspension may be directly given to patient, followed by drinking water. Usual dosage for the treatment of infection: • Adults and children over 40 kg: for severe infections, 875 mg every 12 hours or 500 mg three times daily. • Gonorrhoea: single 3 g dose. • Children's dosage (Children under 40 kg) Standard children's dosage: 125 mg three times daily, increasing to 250 mg three times daily for more severe infections. Note: Moderate infection are certain infection without complication such as septicemia or bactericemia. Severe infection are certain infection with complication such as septicemia or bactericemia.

Patients with renal impairment
In renal impairment the excretion of the antibiotic will be delayed and, depending on the degree of impairment, it may be necessary to reduce the total daily dosage according to the following scheme :
Adults and Children over 40 kg
a. Mild impairment (creatinine clearance > 30 mL/min) : No change in dosage
b. Moderate impairment (creatinine 10- 30 mL/min) : 500 mg b.i.d maximum
c. Severe impairment (creatinineclearance) : 500 mg/day maximum
d. There are currently no dosing recommendations for pediatric patients with impaired renal function.

Patients receiving haemodialysis
Dosing as for patients with severe renal impairment (creatinine clearance < 10 mL/min). They should receive an additional dose both during and at the end of dialysis. Amoxicillin is removed from the circulation by haemodialysis. Therefore, one additional dose (500 mg for adults or 15 mg/kg for children under 40 kg) may be administered during dialysis and at the end of each dialysis. It should be recognized that in the treatment of chronic urinary tract infections, frequent bacteriological and clinical appraisals are necessary. Smaller doses than those recommended above should not be used. Even higher doses may be needed at the times. In stubborn infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy. Except for gonorrhea, treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes symptomatic or evidence of bacterial eradication has been obtained. It is recommended that there be at least 10 days treatment for any infection caused by Streptococcus pyogeness to prevent the occurrence of acute rheumatic fever. Parenteral therapy is indicated if the oral route is considered impracticable or unsuitable, and particularly for the urgent treatment of severe infection.

Precaution

- Before initiating therapy with Amoxicillin, careful inquiry should be made concerning previous hypersensitivity reactions to penicillin.
- Periodic assessment of renal, hepatic and hematopoietic functions should be made during prolonged therapy. - Patient with renal disorder must be monitored for its plasma and urine level.
- Patient with renal disorder must be necessary to reduce the total daily unit amoxicillin dosage.
- As with other antibiotics, Amoxicillin administration may cause superinfection (the common causes are Pseudomonas, Enterobacterium, S. aureus and Candida). If it occurs, treatment should be discontinued and appropriate therapy should be instituted.
- Not for meningitis or body joint treatment (since oral Amoxicillin does not penetrate the cerebrospinal or sinovial liquid).
- Caution should be taken when this drug is administered to patients with lymphatic leukemia due to Amoxicillininduced skin rash susceptibility.
- It may be necessary to reduce the total daily unit amoxicillin dosage accordingly for patients with renal disorder.
- This product contains mannitol; it may cause osmotic diarrhea in some patients.
- Patients with infections mononucleosis (glandular fever), lymphatic leukaemia and possibly with HIV infection are particularly prone to developing erythematous rashes with amoxicillin. Amoxicillin should be discontinued if a skin rash occurs.

When creatinine clearance less than 20 ml / min then
The recommended normal dose should be given once
Or halved if given 2 times a day.
- Or according to doctor's instructions.

Precaution

- The absorption of tablets is affected by the antacids
Containing aluminum or magnesium hydroxide.
So do not get both drugs together,
But must be given 1 to 2 hours before or
After administration of antacids.
- When Ciprofloxacin (1500 mg or more daily) is given
Along with theophylline, there will be an increase
The theophylline levels in the plasma are not
Desired. If theophylline is inevitable,
Theophylline in plasma should be monitored, if
The dose of theophylline should be reduced.
- Consideration of possible interactions should be considered
When administered together with probenecid,
Clindamycin and metronidazole.

Adult:
- mild / moderate urinary tract infection: 2 x 250 mg daily.
- Urinary tract infections: 2 x 500 mg daily.
- mild / moderate infections of the airways, bones, joints,
Skin and soft tissue: 2 x 250 - 500 mg daily.
- Heavy airway infections, bones, joints, skin and tissues
Soft: 2 x 500 - 750 mg daily.
- Chronic prostatitis: 2 x 500 mg.
- Gastrointestinal infections: 2 x 500 mg.
- Acute gonorrhea: 250 mg single dose.
- To obtain adequate levels of osteomyelitis
Acute, the dose should not be less than 2 x
750 mg a day.
The length of treatment depends on the severity of the infection,
Clinical and bacteriological advances. For acute infection,
The duration of treatment is usually 5 -10 days. In general
Treatment should be continued to a minimum
3 days, after clinical symptoms disappear.
Dosage of renal dysfunction:
When creatinine clearance is less than 20 ml / min, then
The normal dose is given only once a day or if given
2 times a day, the dose should be halved.

Precaution

- If during use fluoroquinolone patients
Experiencing pain, swelling, and inflammation
On the tendon and tendon rupture, then
so that:
• Immediately discontinue use of this drug.
• Contact your doctor immediately to consult
Alternative drug replacement.
• Avoid sports activities and other activities
Which uses the affected tendon.
- Ciprofloxacin should be swallowed with enough water
To prevent kristaluria.
- Careful administration of patients with disorders
Kidney function (see DOSE).
- Giving should not exceed the recommended dosage.
- Ciprofloxacin should be given with caution on
Sufferers in the elderly. In cases of epilepsy and patients
Who have experienced CNS disorders (eg
Low seizure threshold, history of convulsions, flow
Blood to brain decreases and stroke), Ciprofloxacin
Only given if the benefits are greater than
The risk, because such patients might be
Suffering from CNS side effects.
- Although taken in accordance with the prescription, medicine
This can disrupt the patient's response, ability
Driving and running the machine. This disorder
Will be more severe if taken with alcohol.
- Just like any other antimicrobial, term delivery
Long can lead to excessive growth
Of less sensitive microorganisms.
- Avoid suffering from excessive sunlight.
When it happens

For treatment of severe infections of inpatients of the house
Pain that can not be given oral or ciprofloxacin
Improper oral administration.
Infections caused by bacteria that are sensitive to
Ciprofloxacin at:
- Urinary tract infections including prostatitis.
- Urethritis and cervicitis gonorrhea.
- Gastrointestinal infections, typhoid fever caused
By Salmonella typhi.
Siprofloksasin efficacy for eradication chronic typhoid
Carrier not yet known.
- Airway infections, except for Strep-
Tococcus.
- Skin and soft tissue infections.
- Bone and joint infections.

Dossage

Adult:
- Uncomplicated kidney infections and salivary infections -
Upper and lower urinary tract: 2 x 100 mg daily.
- Other infections: 2 x 200 mg daily.
- Acute gonorrhea and uncomplicated acute cystitis
In women: a single infusion of 100 mg. After giving
Intravenous treatment can be forwarded orally.
Elderly patients may be given a lower dose
Depending on the severity of the illness and the clearance
Creatinine.
Dosage in patients with impaired renal function:
When creatinine clearance <20 ml / min, then the normal dose
Only given once a day or if given 2 times a day
Then the dose should be halved.

Precaution

- Careful administration of patients with disruptive-
Renal function (see dose).
- Giving should not exceed the recommended dosage.
- Ciprofloxacin should be given with caution on
Elderly people.
- In cases of epilepsy and patients who have been on-
Nerve disorders of the central nervous system (eg threshold
Low seizures, history of convulsions, blood flow to the brain
Reduced and stroke), Ciprofloxacin is only given
If the benefits outweigh the risks,
Na such patients may suffer the effects
Side of the central nervous system.
- Although given according to the prescription, this medicine
Can disrupt the patient's response, ability
Driving and running the machine. This disorder
Will be heavier if given with alcohol.
- Avoid suffering from excessive sunlight -
An. In the event of phototoxicity treatment should be immediate
Stopped.

- Dosage for people with kidney function disorder
* For acute exacerbation of chronic bronchitis, or community-acquired
Pneumonia, or maxillary sinusitis
Acute or skin infections and skin structure without complications,
Dose as follows:

- If hypersensitivity reactions (skin rash, hives or other skin
reactions, a rapid heartbeat, difficulty in swallowing or
breathing, swelling of the lips, tongue, face, tightness
of the throat, hoarseness) or other symptoms of an
allergic occur, the drug should be discontinued.
- Should be used with caution in patients with renal insufficiency
(creatinine clearance < 80 ml/min), adjustment
of the dosage regimen is necessary to avoid the
accumulation of Levofloxacin.
- Observe caution while operating an automobile or
machinery or performing other tasks requiring coordination.
- To discontinue treatment and inform their physician if
they experience pain, inflammation, or rupture of a
tendon.
- To avoid excessive sunlight while receiving Levofloxacin
and to discontinue therapy if phototoxicity occurs.
- That if they are diabetic and are being treated with
insulin or an oral hypoglycemic agent and hypoglycemic
reaction occurs, they should discontinue Levofloxacin
and consult a physician.
- Should be used with caution in any patient with a
known or suspected central nervous system disorder
that may predispose to seizures or lower the seizure
threshold (e.g., severe cerebral arteriosclerosis,
epilepsy) or in the presence of other risk factors that
may predispose to seizures or lower the seizure
threshold.
- Convulsions and toxic psychoses have been reported
in patients receiving quinolones (including Levofloxacin).
Quinolones may also cause increased intracranial
pressure and central nervous system stimulation which
may lead to restlessness, light-headedness, tremors,
hallucinations, depression, paranoia and nightmares. If
these reactions occur, the drug should be discontinued.
- Serious and fatal hypersensitivity reactions often occur
following the first dose. Some reactions have been
accompanied by urticaria, itching and other serious
skin reactions, dyspnea, respiratory obstruction, angioedema,
hypotension/shock and cardiovascular
collapse. The drug should be discontinued at the first
appearance of a skin rash or any other sign of hypersensitivity.
- Treatment with antibacterial agents (including Levofloxacin)
alters the normal flora of the colon and may
permit overgrowth of clostridia. Studies indicate that a
toxin produced by Clostridium difficile is one primary
cause of colitis.
- Pseudomembranous colitis has been reported with
nearly all antibacterial agents (including Levofloxacin),
and may range in severity from mild to lifethreatening.
Therefore, it is important to consider this
diagnosis in patients who present with diarrhea
subsequent to the administration of any antibacterial
agent.
- Periodic assessment of organ system functions, including
renal, hepatic and hematopoietic is advisable
during prolonged therapy. The patient should drink
sufficient fluids to avoid crystalluria.

- LEVOCIN is usually given for 7-14 days depending on the severity of the disease. The usual doses in patients with normal renal function are: 250-500 mg once daily (depending on the type, severity of the infection and the sensitivity of the pathogen causing the infection). Initial treatment i.v. After a few days it is possible to be replaced by oral administration according to the condition of the patient.
- Elderly patients and patients with liver damage (but normal kidney function) may receive normal adult doses.
- Dosage for patients with impaired renal function as follows (creatinine clearance <50 ml / min).

Levofloxacin i.v. Should be given slowly through infusion i.v. For a dose of 500 mg (100 ml) infusion should not be less than 60 minutes. Protection of light during infusion is not necessary.

Precaution

- If hypersensitivity reactions (skin rash, hives or other skin reactions, a rapid heartbeat, difficulty in swallowing or breathing, swelling of the lips, tongue, face, tightness in the throat, hoarseness) or other symptoms of allergy occur, the drug should be discontinued.
- Should be used with caution in patients with renal insufficiency (creatinine clearance < 50 ml/minute), adjustment of the dosage regimen is necessary to avoid the accumulation of Levofloxacin.
- Observe caution while operating an automobile or machinery or performing other tasks requiring coordination.
- Discontinue treatment and inform their physician if they experience pain, inflammation, or rupture of a tendon.
- Avoid excessive sunlight while receiving Levofloxacin and discontinue therapy if phototoxicity occurs.
- If they are diabetic and are being treated with insulin or an oral hypoglycemic agent and hypoglycemic reaction occurs, they should discontinue Levofloxacin and consult a physician.
- Should be used with caution in any patient with a known or suspected central nervous system disorder that may predispose to seizures or lower the seizure threshold (e.g., severe cerebral arteriosclerosis, epilepsy) or in the presence of other risk factors that may predispose to seizure or lower the seizure threshold.
- Convulsion and toxic psychoses have been reported in patients receiving quinolones (including Levofloxacin). Quinolones may also cause increased intracranial pressure and central nervous system stimulation which may lead to restlessness, lightheadedness, tremors, hallucinations, depression, paranoia and nightmares. If these reactions occur, the drug should be discontinued.
- Serious and fatal hypersensitivity reactions often occur following the first dose. Some reactions have been accompanied by urticaria, itching and other serious skin reactions, dyspnea, respiratory obstruction,
angioedema, hypotension, shock and cardiovascular collapse. The drug should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity.
- Treatment with antibacterial agents (including Levofloxacin) alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is one primary cause of colitis.
- Pseudomembranous colitis has been reported with nearly all antibacterial agents (including Levofloxacin), and may range in severity from mild to life threatening. Therefore, it is important to consider this
diagnosis in patients who present with diarrhea subsequent to the administration of any other anti bacterial agent.
- Periodic assessment of organ system functions, including renal, hepatic and hematopoietic is advisable during prolonged therapy. The patient should drink sufficient fluids to avoid crystalluria.